NICOLE RENEE NISSEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****82

License Status

ACTIVE

Business

First Name

NICOLE

Middle

RENEE

Last Name

NISSEN

Business Name

NICOLE RENEE NISSEN

Original Issue Date

04/08/2022

Effective Date

03/17/2026

Expiration Date

05/31/2028

City

FREEBURG

State

Zip

62243

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026